サルモネラ菌（Salmonella enteritidis）による感染性腸炎の2例

Infectious Enterocolitis due to Salmonella Enteritidis, Report of Two Cases

要旨　〔症例1〕は37歳，女性．40℃以上の発熱，数十行/日にも及ぶ水様性下痢を主訴として，精査治療目的に当科受診した．大腸内視鏡検査でS状結腸近位側から回腸に至るまで血管透見像の消失と軽度浮腫性変化を伴った病変をびまん性に認め，生検および便汁から細菌検査を施行，S. enteritidisを検出した．〔症例2〕は60歳，男性．3～4行/日の水様性下痢と腹痛を主訴として精査治療目的に当科受診した．大腸内視鏡検査で回盲弁の腫脹と回盲弁上唇に白苔を伴う不整形の比較的大きい浅い潰瘍を認め，便汁のほかに回盲弁より生検で得た組織を細菌検査に提出，S. enteritidisを検出した．以上より2症例ともS. enteritidisによる感染性腸炎と診断し，文献的考察を加えて報告した．

　A 37-year-old female had gradually developed watery diarrhea and high fever (over 40℃) for two days before she was admitted to our hospital. A diagnosis of enterocolitis was made tentatively, because she had symptoms of enterocolitis and abnormality of laboratory data due to some kind of bacterial infection. Colonoscopic examination showed absence of the vascular network pattern, diffuse edematous change and slightly erosive change on the diffuse mucosa between the terminal ileum and the sigmoid colon. Cultures were made and examined using biopsy specimens and fecal samples, and grew Salmonella enteritidis. A definite diagnosis of infectious enterocolitis due to Salmonella enteritidis was made. After antibiotic therapy, she grew better day by day and was discharged. A 60-year-old male was admitted to our hospital for watery diarrhea and abdominal pain. Colonoscopic examination on admission showed white coated and shallow ulceration on the ileocecal valve. However, it didn't show absence of the vascular network pattern, edematous change and erosive change in the terminal ileum and overall colonic mucosa. Cultures were made using biopsy specimens from the ulceration and fecal samples, and both cultures yielded Salmonella enteritidis. A definite diagnosis of infectious enterocolitis due to Salmonella enteritidis was made. He was symptom-free after antibiotic therapy, and was followed up in our clinic for three weeks. Although both cases had the same symptoms and the same bacteria, Salmonella enteritidis, their colonoscopic examinations showed different findings. We suggested that this difference was caused by the mechanism of infection and the volume of bacteria.